MRS. JENNIFER NICKELL MS RD LD NPI 1164832713

NPI Information

NPI: 1164832713
Provider Name: MRS. JENNIFER NICKELL, MS, RD, LD
Classification: Dietitian, Registered - 133VN1004X
Specialization: Nutrition, Pediatric
Entity Type: Individual
Address: 4948 SW MEADOW AVE
LAKE OSWEGO, OR
ZIP 97035
Phone: (503) 744-2061

Map and Directions

Get Directions

NPI Details

MRS. Jennifer Nickell, MS, RD, LD is a nutrition and pediatric dietitian registered in Lake Oswego, OR with 19 years of experience. The provider is an individual who is a Board Certified Specialist in Pediatric Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for pediatric patients. Specialists work directly with healthy and/or ill children (newborn up to 21 years of age) as well as children with special health care needs in a variety of settings (hospitals, community-based and/or family-centered programs, education programs, home, etc.), OR indirectly through management, care coordination, education, quality improvement, or research practice linked specifically to pediatric nutrition. MRS. Jennifer Nickell, MS, RD, LD NPI is 1164832713. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4948 SW MEADOW AVE
LAKE OSWEGO, OR
ZIP 97035-216
Phone: (503) 744-2061

The enumeration date for this NPI number is 5/5/2014 and was last updated on 1/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	133V00000X	Dietitian, Registered		LD-D-10159758	OREGON	No
2	133VN1004X	Dietitian, Registered	Nutrition, Pediatric	966403		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	966403	OTHER		COMMISSION ON DIETETIC REGISTRATION

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI

Next NPI